Heterogeneity is the main clinical feature of prostate cancer and is manifest in the tumor histological characteristics between different patients as well as tumor cell growth and metastasis speed in the same patient. Thus, it is very important to establish corresponding individualized animal models to develop clinical treatments for prostate cancer. Patient-derived organoid (PDO) models accurately display the tissue structure, function, and genetic characteristics of prostate cancer in vivo, which reflect the heterogeneity of clinical tissues. PDO models have unique advantages when applied to prostate cancer research. We summarize the culture conditions of prostate cancer PDO models, and review the application of these in vitro models for research related to the pathogenesis, drug screening, individualized treatment, and drug resistance mechanisms of prostate cancer to provide a perfect model for heterogeneity research in prostate cancer.